How to treat periodontitis – Insights from a Periodontist in Singapore

Young woman at dental consultation

There is a study that says teeth are connected to other parts of our body. Have you ever noticed that when you have a toothache, it causes a headache too? By evaluating your dental health, your overall health and wellness can also be ascertained because of the connection of the teeth to the other organs of the body.

If you think you have gum problems, this article by a trusted and well-experienced periodontist in Singapore will be a big help. In this article, Dr. Marlene Teo gives usher insights on periodontitis and periodontal treatments in Singapore.

Brushing and flossing regularly is not enough to get healthy teeth. You also need to visit your dentist regularly because you might miss some signs and symptoms of tooth decay or gum disease. The earlier oral problems can be detected and treated, the better.

What is a periodontist?

A periodontist is a dentist who specializes in the diagnosis, prevention, and treatment of gum diseases (periodontal diseases) as well as dental implants placement. They carry out surgical procedures for severe gum diseases and repair, place and maintain dental implants. Periodontists in Singapore have to go through an additional 3 years of extensive training on treatment and management of periodontal diseases as well as cosmetic periodontal procedures.

What is periodontitis?

Periodontitis disease

“Perio" means around and “dontal" pertains to teeth. Periodontitis or periodontal disease is an infection of the structures around teeth. It includes the gums, periodontal ligament, and alveolar bone. The major causes of this disease are plaque and tartar, the accumulation of bacteria on the base or surface of the teeth. My patients always think that plaque will not cause much harm to their teeth but little do they know that it can get worse and lead to periodontitis. Here is how plaque can progress to periodontitis:

  • When starch and sugar interacts with the bacteria found in your mouth, plaque forms on your teeth. To remove plaque, you have to brush your teeth twice a day and floss once a day. Without proper oral hygiene, plaque can form very quickly.
  • When plaque stays on your teeth, it will get hardened under the gum line and form into tartar. Brushing and flossing cannot remove tartar. A dental cleaning from the dentist will be required to completely remove tartar buildup.
  • Plaque causes gingivitis. It is a mild form of gum disease that irritates and inflames the part of gum tissues around the teeth. It can be managed with good dental habits at home and requires treatment from a dentist or periodontist.
  • If plaque, bacteria, and tartar are left untreated, they can cause periodontitis. Dental pockets at the gum tissues become filled with bacteria and can cause loss of gum tissue or bones supporting the teeth.

Risk Factors

Here are the risk factors that can increase the risk of periodontitis:

  • Genetics
  • Poor dental health habits
  • Gingivitis
  • Hormonal changes like pregnancy
  • Smoking, vaping or chewing tobacco
  • Lack of proper nutrition
  • Medications that can cause gum changes or dry mouth
  • Diseases like diabetes and rheumatoid arthritis
  • Obesity

Periodontitis can also lead to complications by affecting the other parts of your body. It can be linked to diabetes where blood sugar is difficult to control, coronary artery disease and respiratory disease. Your immune system may be also at risk.

Diagnosing Periodontitis

To diagnose periodontitis in my patients, I always check first their medical history to see if what contributes to the signs and symptoms. I check if they are smoking or taking medicines that cause their mouth to dry up. I examine their mouth to check for plaque and tartar. Then I measure the depth of the gum pockets. If they are deeper than 4 mm, that indicates that they have periodontitis. And lastly, I request for dental x-rays to check for possible bone loss.


Periodontitis treatment in dental clinic

There are two types of treatment for periodontitis: Non-Surgical and Surgical treatment. The treatment depends on the severity of the condition.

Non-Surgical Treatment

  1. Scaling - it removes tartar and bacteria from your tooth surface by the use of a laser or ultrasonic device.
  2. Root planning - it prevents further buildup of tartar and bacteria. It also smoothens root surfaces.
  3. Antibiotics - it helps control bacterial infections. It can be an oral or topical antibiotic. They can also be in the form of gels that contain antibiotics that will be inserted into gum pockets.

Surgical Treatments

  1. Flap surgery - is also called pocket reduction surgery. A tiny incision is made so that the gum tissue can be lifted and it will be easier to do scaling and root planing.
  2. Soft tissue grafts - cover roots that are exposed by removing a small amount of tissue in the palate and attaching it to the affected site. This treatment also gives teeth a more pleasant appearance.
  3. Bone grafting - when periodontitis destroyed the bone around the tooth, this treatment is performed. It helps prevent tooth loss by supporting the tooth in place and serves as a guide for the regrowth of the natural bone.
  4. Tissue-stimulating proteins - this uses a gel that contains the same proteins used in developing tooth enamel. It is applied to the affected tooth root.
  5. Guided tissue regeneration - it uses a bio-compatible fabric between the existing tooth and bone. It allows the regrowth of the bone destroyed by bacteria.

You can also refer to this list for a more comprehensive breakdown of the surgical options available.


I always give my patients reminders on how to take good care of their teeth. Brushing teeth twice a day is a must. Using a soft toothbrush and replacing it every three months is a must too. I also encourage them to come to their scheduled appointment for dental cleanings.

Dr Marlene Teo
360 Orchard Rd, #03-06/07 next to Lido,
International Building, Singapore 238869
+65 8588 9868

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